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Schut PC, Brosens E, Van Dooren TJM, Galis F, Ten Broek CMA, Baijens IMM, Dremmen MHG, Tibboel D, Schol MP, de Klein A, Eggink AJ, Cohen-Overbeek TE. Exploring copy number variants in deceased fetuses and neonates with abnormal vertebral patterns and cervical ribs. Birth Defects Res 2020; 112:1513-1525. [PMID: 32755042 PMCID: PMC7689732 DOI: 10.1002/bdr2.1786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/03/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022]
Abstract
Background Cervical patterning abnormalities are rare in the general population, but one variant, cervical ribs, is particularly common in deceased fetuses and neonates. The discrepancy between the incidence in the general population and early mortality is likely due to indirect selection against cervical ribs. The cause for the co‐occurrence of cervical ribs and adverse outcome remains unidentified. Copy number variations resulting in gain or loss of specific genes involved in development and patterning could play a causative role. Methods Radiographs of 374 deceased fetuses and infants, including terminations of pregnancies, stillbirths and neonatal deaths, were assessed. Copy number profiles of 265 patients were determined using single nucleotide polymorphism array. Results 274/374 patients (73.3%) had an abnormal vertebral pattern, which was associated with congenital abnormalities. Cervical ribs were present in 188/374 (50.3%) and were more common in stillbirths (69/128 [53.9%]) and terminations of pregnancies (101/188 [53.7%]), compared to live births (18/58, 31.0%). Large (likely) deleterious copy number variants and aneuploidies were prevalent in these patients. None of the rare copy number variants were recurrent or overlapped with candidate genes for vertebral patterning. Conclusions The large variety of copy number variants in deceased fetuses and neonates with similar abnormalities of the vertebral pattern probably reflects the etiological heterogeneity of vertebral patterning abnormalities. This genetic heterogeneity corresponds with the hypothesis that cervical ribs can be regarded as a sign of disruption of critical, highly interactive stages of embryogenesis. The vertebral pattern can probably provide valuable information regarding fetal and neonatal outcome.
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Affiliation(s)
- Pauline C Schut
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tom J M Van Dooren
- Naturalis Biodiversity Center, Leiden, The Netherlands.,CNRS, Institute of Ecology and Environmental Sciences iEES Paris, Sorbonne University, Paris, France
| | | | | | - Inge M M Baijens
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marjolein H G Dremmen
- Department of Radiology, Division of Paediatric Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dick Tibboel
- Department of Paediatric Surgery, Erasmus MC, Erasmus University Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Martin P Schol
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alex J Eggink
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Titia E Cohen-Overbeek
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Ostrom QT, Fahmideh MA, Cote DJ, Muskens IS, Schraw JM, Scheurer ME, Bondy ML. Risk factors for childhood and adult primary brain tumors. Neuro Oncol 2019; 21:1357-1375. [PMID: 31301133 PMCID: PMC6827837 DOI: 10.1093/neuonc/noz123] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Primary brain tumors account for ~1% of new cancer cases and ~2% of cancer deaths in the United States; however, they are the most commonly occurring solid tumors in children. These tumors are very heterogeneous and can be broadly classified into malignant and benign (or non-malignant), and specific histologies vary in frequency by age, sex, and race/ethnicity. Epidemiological studies have explored numerous potential risk factors, and thus far the only validated associations for brain tumors are ionizing radiation (which increases risk in both adults and children) and history of allergies (which decreases risk in adults). Studies of genetic risk factors have identified 32 germline variants associated with increased risk for these tumors in adults (25 in glioma, 2 in meningioma, 3 in pituitary adenoma, and 2 in primary CNS lymphoma), and further studies are currently under way for other histologic subtypes, as well as for various childhood brain tumors. While identifying risk factors for these tumors is difficult due to their rarity, many existing datasets can be leveraged for future discoveries in multi-institutional collaborations. Many institutions are continuing to develop large clinical databases including pre-diagnostic risk factor data, and developments in molecular characterization of tumor subtypes continue to allow for investigation of more refined phenotypes. Key Point 1. Brain tumors are a heterogeneous group of tumors that vary significantly in incidence by age, sex, and race/ethnicity.2. The only well-validated risk factors for brain tumors are ionizing radiation (which increases risk in adults and children) and history of allergies (which decreases risk).3. Genome-wide association studies have identified 32 histology-specific inherited genetic variants associated with increased risk of these tumors.
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Affiliation(s)
- Quinn T Ostrom
- Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Maral Adel Fahmideh
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine, Solna, Karolinska Institutet, and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - David J Cote
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Computational Neuroscience Outcomes Center, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Ivo S Muskens
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jeremy M Schraw
- Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Melissa L Bondy
- Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
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Kalelioglu IH, Gursoy Erzincan S, Erturk E, Has R. Prenatal Incidence and Clinical Value of the Absence of 12th Ribs in a Population in a Setting of Detailed Second-Trimester Sonography. Fetal Diagn Ther 2019; 46:368-375. [PMID: 30970358 DOI: 10.1159/000497159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/21/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We aimed to determine the incidence of the absence of the (last) 12th ribs in a population in a setting of detailed 2nd-trimester sonography using three-dimensional (3D) ultrasound and to assess whether or not this may be related to chromosomal aneuploidies. METHODS Prospectively, we counted fetal ribs for the absence of the (last) 12th ribs in singleton pregnancies of women who presented to our clinic for detailed 2nd-trimester sonography. The assessment was carried out using 3D ultrasound. Volume data sets were acquired with the 3D skeleton mode using the maximum intensity with X-ray-weighted rendering. If the 3D skeleton mode was not sufficient, volume contrast imaging with the OmniView bone mode was used. RESULTS The fetal ribs could be visualized in 97.01% of the 1,943 fetuses examined between 20 and 23 weeks' gestation. Timing the examination at 21, 22, or 23 weeks was found to be more successful than conducting it at 20 weeks. Twelfth ribs were found to be absent in 33 fetuses; 16 fetuses had 11 ribs unilaterally and 17 had so bilaterally. None of them had chromosomal abnormalities. Associated anomalies were present in 6 fetuses (18.2%); 2 of the anomalies were major and 4 minor. CONCLUSION The incidence of absent 12th ribs in this mixed population was 1.75%. In the absence of additional anomalies, the prognosis is favorable.
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Affiliation(s)
- Ibrahim Halil Kalelioglu
- Department of Obstetrics and Gynecology, Istanbul University Faculty of Medicine, Istanbul, Turkey,
| | - Selen Gursoy Erzincan
- Department of Obstetrics and Gynecology, Trabzon Kanuni Research and Teaching Hospital, Trabzon, Turkey
| | - Emircan Erturk
- Department of Obstetrics and Gynecology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Recep Has
- Department of Obstetrics and Gynecology, Istanbul University Faculty of Medicine, Istanbul, Turkey
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Schut PC, Ten Broek CMA, Cohen-Overbeek TE, Bugiani M, Steegers EAP, Eggink AJ, Galis F. Increased prevalence of abnormal vertebral patterning in fetuses and neonates with trisomy 21. J Matern Fetal Neonatal Med 2018; 32:2280-2286. [PMID: 29353507 DOI: 10.1080/14767058.2018.1431622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To assess the prevalence of an abnormal number of ribs in a cohort of fetuses and neonates with trisomy 21 and compare this with a subgroup of fetuses without anomalies. MATERIALS AND METHODS Radiographs of 67 deceased fetuses, neonates, and infants that were diagnosed with trisomy 21 were reviewed. Terminations of pregnancy were included. The control group was composed of 107 deceased fetuses, neonates, and infants without known chromosomal abnormalities, structural malformations, infections or placental pathology. Cases in which the number of thoracic ribs or presence of cervical ribs could not be reliably assessed were excluded. The literature concerning vertebral patterning in trisomy 21 cases and healthy subjects was reviewed. RESULTS Absent or rudimentary 12th thoracic ribs were found in 26/54 (48.1%) cases with trisomy 21 and cervical ribs were present in 27/47 (57.4%) cases. This prevalence was significantly higher compared to controls (28/100, 28.0%, Χ2(1) = 6.252, p = .012 and 28/97, 28.9%, Χ2(1) = 10.955, p < .001, respectively). CONCLUSIONS Rudimentary or absent 12th thoracic ribs and cervical ribs are significantly more prevalent in deceased fetuses and infants with trisomy 21.
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Affiliation(s)
- Pauline C Schut
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | | | - Titia E Cohen-Overbeek
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Marianna Bugiani
- c Department of Pathology , VU University Medical Centre , Amsterdam , The Netherlands
| | - Eric A P Steegers
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Alex J Eggink
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Frietson Galis
- b Naturalis Biodiversity Center , Leiden , The Netherlands
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Henry BM, Vikse J, Sanna B, Taterra D, Gomulska M, Pękala PA, Tubbs RS, Tomaszewski KA. Cervical Rib Prevalence and its Association with Thoracic Outlet Syndrome: A Meta-Analysis of 141 Studies with Surgical Considerations. World Neurosurg 2017; 110:e965-e978. [PMID: 29203316 DOI: 10.1016/j.wneu.2017.11.148] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 11/23/2017] [Accepted: 11/25/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cervical ribs (CR) are supernumerary ribs that arise from the seventh cervical vertebra. In the presence of CR, the boundaries of the interscalene triangle can be further constricted and result in neurovascular compression and thoracic outlet syndrome (TOS). The aim of our study was to provide a comprehensive evidence-based assessment of CR prevalence and their association with TOS as well as surgical approach to excision of CR and surgical patients' characteristics. METHODS A thorough search of major electronic databases was conducted to identify any relevant studies. Data on the prevalence, laterality, and side of CR were extracted from the eligible studies for both healthy individuals and patients with TOS. Data on the type of TOS and surgical approach to excision of CR were extracted as well. RESULTS A total of 141 studies (n = 77,924 participants) were included into the meta-analysis. CR was significantly more prevalent in patients with TOS than in healthy individuals, with pooled prevalence estimates of 29.5% and 1.1%, respectively. More than half of the patients had unilateral CR in both the healthy and the TOS group. The analysis showed that 51.3% of the symptomatic patients with CR had vascular TOS, and 48.7% had neurogenic TOS. Most CR were surgically excised in women using a supraclavicular approach. CONCLUSIONS CR ribs are frequent findings in patients with TOS. We recommended counseling asymptomatic patients with incidentally discovered CR on the symptoms of TOS, so that if symptoms develop, the patients can undergo prompt and appropriate workup and treatment.
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Affiliation(s)
- Brandon Michael Henry
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland; International Evidence-Based Anatomy Working Group, Krakow, Poland.
| | - Jens Vikse
- International Evidence-Based Anatomy Working Group, Krakow, Poland; Department of Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Beatrice Sanna
- International Evidence-Based Anatomy Working Group, Krakow, Poland; Faculty of Medicine and Surgery, University of Cagliari, Monserrato, Italy
| | - Dominik Taterra
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland; International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - Martyna Gomulska
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Przemysław A Pękala
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland; International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - R Shane Tubbs
- Seattle Science Foundation, Seattle, Washington, USA
| | - Krzysztof A Tomaszewski
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland; International Evidence-Based Anatomy Working Group, Krakow, Poland
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Johnson KJ, Lee JM, Ahsan K, Padda H, Feng Q, Partap S, Fowler SA, Druley TE. Pediatric cancer risk in association with birth defects: A systematic review. PLoS One 2017; 12:e0181246. [PMID: 28749971 PMCID: PMC5716403 DOI: 10.1371/journal.pone.0181246] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/28/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Many epidemiological studies have examined associations between birth defects (BDs) and pediatric malignancy over the past several decades. Our objective was to conduct a systematic literature review of studies reporting on this association. METHODS We used librarian-designed searches of the PubMed Medline and Embase databases to identify primary research articles on pediatric neoplasms and BDs. English language articles from PubMed and Embase up to 10/12/2015, and in PubMed up to 5/12/2017 following an updated search, were eligible for inclusion if they reported primary epidemiological research results on associations between BDs and pediatric malignancies. Two reviewers coded each article based on the title and abstract to identify eligible articles that were abstracted using a structured form. Additional articles were identified through reference lists and other sources. Results were synthesized for pediatric cancers overall and for nine major pediatric cancer subtypes. RESULTS A total of 14,778 article citations were identified, of which 80 met inclusion criteria. Pediatric cancer risk was increased in most studies in association with BDs overall with some notable specific findings, including increased risks for CNS tumors in association with CNS abnormalities and positive associations between rib anomalies and several pediatric cancer types. CONCLUSIONS Some children born with BDs may be at increased risk for specific pediatric malignancy types. This work provides a foundation for future investigations that are needed to clarify specific BD types predisposing toward malignancy and possible underlying causes of both BDs and malignancy.
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Affiliation(s)
- Kimberly J. Johnson
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
- Department of Pediatrics, Washington University School of Medicine,
Washington University in St. Louis, St. Louis, Missouri, United States of
America
- * E-mail:
| | - Jong Min Lee
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Kazi Ahsan
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Hannah Padda
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Qianxi Feng
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Sonia Partap
- Department of Neurology, Stanford University, Palo Alto, California,
United States of America
| | - Susan A. Fowler
- Brown School, Washington University in St. Louis, St. Louis, Missouri,
United States of America
| | - Todd E. Druley
- Department of Pediatrics, Washington University School of Medicine,
Washington University in St. Louis, St. Louis, Missouri, United States of
America
- Division of Pediatric Hematology and Oncology, Washington University
School of Medicine, Washington University in St. Louis, St. Louis, Missouri,
United States of America
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Boer L, Radziun AB, Oostra R. Frederik Ruysch (1638-1731): Historical perspective and contemporary analysis of his teratological legacy. Am J Med Genet A 2017; 173:16-41. [PMID: 27126916 PMCID: PMC5215407 DOI: 10.1002/ajmg.a.37663] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 03/28/2016] [Indexed: 11/07/2022]
Abstract
The Peter the Great Museum of Anthropology and Ethnography (Kunstkamera) in Saint Petersburg is the oldest museum in Russia. It keeps the remains of the anatomical collection of the world-famous 17th century Dutch anatomist Frederik Ruysch. This unique collection was bought and shipped in 1717 by Czar Peter the Great, and presently still comprises more than 900 specimens, a modest number of which concerns specimens with congenital anomalies. We searched for teratological clues in the existing collection and in all his descriptions and correspondence regarding specimens and cases he encountered during his career as doctor anatomiae and chief instructor of the surgeons and midwives in Amsterdam. A total of 63 teratological specimens and case descriptions were identified in this legacy, including some exceedingly rare anomalies. As it turns out, Ruysch was the first to describe several of the conditions we encountered, including intracranial teratoma, enchondromatosis, and Majewski syndrome. Although his comments pose an interesting view on how congenital anomalies were scientifically perceived in early 18th century Europe, Ruysch mostly refrained from explaining the causes of the conditions he encountered. Instead, he dedicated himself to careful descriptions of his specimens. Almost 300 years after his demise, Ruysch's legacy still impresses and inspires both scientists and lay men. © 2016 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Lucas Boer
- Department of Anatomy and Museum for Anatomy and PathologyRadboud University Medical CentreNijmegenThe Netherlands
| | - Anna B. Radziun
- Peter the Great Museum of Anthropology and EthnographyRussian Academy of SciencesSaint PetersburgRussia
| | - Roelof‐Jan Oostra
- Department of AnatomyEmbryology and PhysiologyAcademic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
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Adverse Fetal and Neonatal Outcome and an Abnormal Vertebral Pattern: A Systematic Review. Obstet Gynecol Surv 2016; 71:741-750. [DOI: 10.1097/ogx.0000000000000388] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ghandhari H, Tari HV, Ameri E, Safari MB, Fouladi DF. Vertebral, rib, and intraspinal anomalies in congenital scoliosis: a study on 202 Caucasians. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 24:1510-21. [DOI: 10.1007/s00586-015-3833-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 02/17/2015] [Accepted: 02/19/2015] [Indexed: 10/23/2022]
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Spencer HT, Gold ME, Hresko MT. Abnormal rib count in scoliosis surgery: impact on the reporting of spinal fusion levels. J Child Orthop 2014; 8:497-503. [PMID: 25370702 PMCID: PMC4252269 DOI: 10.1007/s11832-014-0623-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 10/20/2014] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Variation in rib numbering has been noted in adolescent idiopathic scoliosis (AIS), but its effect on the reporting of fusion levels has not been studied. We hypothesized that vertebral numbering variations can lead to differing documentation of fusion levels. METHODS We examined the radiographs of 161 surgical AIS patients and 179 control patients without scoliosis. For AIS patients, the operative report of fusion levels was compared to conventional vertebral labeling from the first thoracic level and proceeding caudal. We defined normal counts as 12 thoracic (rib-bearing) and five lumbar (non-rib-bearing) vertebrae. We compared our counts with data from 181 anatomic specimens. RESULTS Among AIS patients, 22 (14 %) had an abnormal number of ribs and 29 (18 %) had either abnormal rib or lumbar count. In 12/29 (41 %) patients, the operative report differed from conventional labeling by one level, versus 3/132 (2 %) patients with normal numbering (p < 0.001). However, there were no cases seen of wrong fusion levels based on curve pattern. Among controls, 11 % had abnormal rib count (p = 0.41) compared to the rate in AIS. Anatomic specimen data did not differ in abnormal rib count (p = 1.0) or thoracolumbar pattern (p = 0.59). CONCLUSIONS The rate of numerical variations in the thoracolumbar vertebrae of AIS patients is equivalent to that in the general population. When variations in rib count are present, differences in numbering levels can occur. In the treatment of scoliosis, no wrong fusion levels were noted. However, for both scoliosis patients and the general population, we suggest adherence to conventional labeling to enhance clarity.
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Affiliation(s)
- Hillard T Spencer
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Hunnewell 2, Boston, MA, 02115, USA,
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Khodair SA, Hassanen OA. Abnormalities of fetal rib number and associated fetal anomalies using three dimensional ultrasonography. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ramalho C, Brandão O, Matias A, Montenegro N. Phenotypic variability in fetuses with down syndrome: a case-control pathological evaluation. Fetal Diagn Ther 2011; 30:207-14. [PMID: 21952468 DOI: 10.1159/000329309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 05/10/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Evaluation of morphological and morphometric characteristics of fetuses with Down syndrome based on a detailed postmortem examination and comparison of these fetuses with a control group of fetuses with normal karyotype to improve the prenatal knowledge of Down syndrome characteristics. MATERIAL AND METHODS A case-control study was undertaken in a tertiary referral hospital. The Down syndrome fetuses (50) were compared with chromosomally normal fetuses (47) matched for gestational age. Biometric and morphological parameters were compared. RESULTS The biometry of fetuses with Down syndrome differs from control fetuses only in the occipitofrontal diameter and in the nasal bone length. There were craniofacial anomalies in 96% of fetuses with Down syndrome and in 51% of fetuses with normal karyotype. With the exception of small ears, all craniofacial features analyzed were significantly different between Down syndrome fetuses and control fetuses. All extremity features of fetuses with Down syndrome were significantly different from fetuses without Down syndrome. There were 31 fetuses with Down syndrome (62%) with 55 internal anomalies. Nineteen fetuses (38.8%) showed 27 cardiac anomalies. Six fetuses had more than one anomaly. There were 18 fetuses (36%) with 28 noncardiac anomalies. DISCUSSION The importance of studying the morphological characteristics of fetuses with Down syndrome is the contribution to a better knowledge of fetal characteristics and probably to optimize prenatal diagnosis.
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Affiliation(s)
- C Ramalho
- Center of Prenatal Diagnosis, Department of Gynecology and Obstetrics, Centro Hospitalar S. João, Medical Faculty of Porto, Porto, Portugal.
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Abstract
Background: Congenital anomalies have been found more often in children with cancer than in those without. Rib abnormalities (RAs) have been associated with childhood cancer; however, studies have differed in the type of RAs and cancers implicated. Methods: Rib abnormalities were assessed predominantly by X-ray in a hospital-based case–control study. Results: There was a significant difference in the number of cases vs controls with RAs after controlling for age and sex, specifically for acute myelogenous leukaemia, renal tumours, and hepatoblastoma. Conclusion: The results of this study support previous reports that there is an association of rib anomalies with childhood cancer.
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Johnson KJ, Roesler MA, Linabery AM, Hilden JM, Davies SM, Ross JA. Infant leukemia and congenital abnormalities: a Children's Oncology Group study. Pediatr Blood Cancer 2010; 55:95-9. [PMID: 20486175 PMCID: PMC2904947 DOI: 10.1002/pbc.22495] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Leukemia in infants is rare and has not been well studied apart from leukemia in older children. Differences in survival and the molecular characteristics of leukemia in infants versus older children suggest a distinct etiology, likely involving prenatal factors. PROCEDURE We examined the association between eight categories of maternally reported congenital abnormalities (CAs) (cleft lip or palate, spina bifida or other spinal defect, large or multiple birthmarks, other chromosomal abnormalities, small head or microcephaly, rib abnormalities, urogenital abnormalities, and other) and infant leukemia in a case-control study. The study included 443 cases diagnosed at <1 year of age at a Children's Oncology Group Institution in the United States or Canada from 1996 to 2006 and 324 controls. Controls were recruited from the cases' geographic area either by random digit dialing (1999-2002) or through birth certificates (2003-2008) and were frequency-matched to cases on birth year. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for birth year and a measure of follow-up time to account for differences in the CA observation period. RESULTS No statistically significant associations were observed between infant leukemia and any CA (OR = 1.2; 95% CI: 0.8-1.9), birthmarks (OR = 1.4; 95% CI: 0.7-2.5), urogenital abnormalities (OR = 0.7; 95% CI: 0.2-2.0), or other CA (OR = 1.4; 95% CI: 0.7-2.8). Results were similar for acute lymphoblastic and myeloid leukemia cases. Fewer than five subjects were in the remaining CA categories precluding analysis. CONCLUSIONS Overall, we did not find evidence to support an association between CAs and infant leukemia.
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Affiliation(s)
- Kimberly J. Johnson
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN
| | - Michelle A. Roesler
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN
| | - Amy M. Linabery
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN
| | - Joanne M. Hilden
- Department of Pediatric Hematology/Oncology, Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, IN
| | | | - Julie A. Ross
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN
,Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455
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Pape H, Orth K, Engers R, Matuschek C, Müller A, Hartmann KA, Gerber PA, Lammering G, Habermehl D, Fenk R, Budach W, Gripp S, Peiper M, Bölke E. Radiotherapie der Weichteilsarkome – Teil einer multidisziplinären Strategie. Wien Klin Wochenschr 2008; 120:723-31. [DOI: 10.1007/s00508-008-1115-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 11/19/2008] [Indexed: 11/29/2022]
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Hershkovitz R. Prenatal diagnosis of isolated abnormal number of ribs. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 32:506-509. [PMID: 18537105 DOI: 10.1002/uog.5296] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To determine the incidence of prenatal isolated abnormal number of ribs, using three-dimensional (3D) ultrasound. METHODS This was a prospective study of low-risk women with singleton pregnancy and normal fetal anatomy scan. 3D examinations of the fetal ribs were carried out at the time of the routine anomaly scan at 14-16 or 20-24 weeks of gestation. A 3D volume of the spine was acquired with a mechanical sweep that lasted between 2 and 4 s per volume and was performed when the fetus had a minimally flexed head position. Fetal ribs were reviewed on the rendered image (maximal mode), both while the patient was in the clinic and again later. RESULTS Three hundred and sixty-seven pregnant women were evaluated. Twenty-three (6.3%) fetuses were found to have an abnormal number of ribs. Fifteen (4.1%) had 11 ribs unilaterally, with the last (12(th)) rib missing. One patient (0.27%) had 13 ribs unilaterally (with a small extra rib after the last rib). Two (0.5%) patients had 13 ribs bilaterally with an extra rib after the 12(th) rib on each side and two (0.5%) patients had 13 ribs bilaterally with an extra cervical rib on each side. Three (0.8%) patients had an extra unilateral cervical rib. In all, 1.4% of patients had extra cervical ribs. CONCLUSIONS The incidence of abnormal number of ribs in this normal population was 6.3%. When isolated, this finding is a normal variant.
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Affiliation(s)
- R Hershkovitz
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Ultrasound Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Gindes L, Benoit B, Pretorius DH, Achiron R. Abnormal number of fetal ribs on 3-dimensional ultrasonography: associated anomalies and outcomes in 75 fetuses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2008; 27:1263-1271. [PMID: 18716135 DOI: 10.7863/jum.2008.27.9.1263] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this study was to describe the clinical importance of an abnormal number of fetal ribs. METHODS A retrospective study of all fetuses that were found to have an abnormal number of ribs during routine ultrasonographic examinations was performed. Volume data sets of the fetal ribs were acquired by either static 3- or 4-dimensional volume contrast imaging in plane C. In all cases, a meticulous survey of the fetal anatomy was performed, and prenatal and postnatal records were reviewed. RESULTS Seventy-five fetuses were found retrospectively to have an abnormal number of ribs. Ultrasonographic examinations were done between 14 and 31 weeks' gestation (mean, 21.8 weeks; median, 23 weeks). More than 24 ribs were found in 28 fetuses (37%), and fewer than 24 ribs were found in 47 (63%). Additional anomalies were found in 22 fetuses (29%). Cardiovascular anomalies were detected in 10 fetuses. Seven fetuses had renal anomalies. Two fetuses had mild ventriculomegaly, and 1 fetus had holoprosencephaly. Lung dysplasia was found in 2 cases. One fetus had enlarged nuchal translucency with wormian bones. Termination of pregnancy was performed in 3 cases because of major malformations. The other 19 fetuses with associated abnormalities and the 53 without associated anomalies were born alive with only minor anomalies. CONCLUSIONS An abnormal number of fetal ribs is an isolated finding in most cases. It may also be seen with major anomalies; however, more frequently the anomalies are minor, and the overall prognosis is good.
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Affiliation(s)
- Liat Gindes
- Department of Obstetrics and Gynecology, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel-Aviv University, Ramat Gan, Israel .
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Bjorge T, Cnattingius S, Lie RT, Tretli S, Engeland A. Cancer Risk in Children with Birth Defects and in Their Families: A Population Based Cohort Study of 5.2 Million Children from Norway and Sweden. Cancer Epidemiol Biomarkers Prev 2008; 17:500-6. [DOI: 10.1158/1055-9965.epi-07-2630] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bibliography. Current world literature. Hematology and oncology. Curr Opin Pediatr 2008; 20:107-13. [PMID: 18197049 DOI: 10.1097/mop.0b013e3282f572b6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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